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History of Childhood Maltreatment Linked to Higher Rates of Unemployment, Poverty

Outcomes of Abuse and Neglect Impose Significant Costs to Individual and Society

October 15, 2009 • Science Update

The long-term impacts of childhood maltreatment include higher rates of unemployment, poverty, and use of social services in adulthood, according to a new study by David Zielinski, Ph.D., of the NIMH Office of Science Policy, Planning, and Communications.1 The related losses in productivity and tax revenues, increased spending on social services, and potential transmission of abusive behaviors from one generation to the next, suggest major costs to society as well. The results were published online ahead of print on October 8, 2009, in the journal Child Abuse and Neglect.

Background

Research has shown that negative early life experiences can adversely affect a person's physical and mental health in adulthood.2,3 However, few studies have focused on the association between childhood maltreatment and later socioeconomic well-being.

To address this research gap, Zielinski evaluated data on childhood maltreatment and socioeconomic well-being from the NIMH-funded National Comorbidity Survey (NCS). The NCS was the first study to estimate the prevalence of mental disorders (using modern psychiatric standards) in a representative sample of the general U.S. population. Due to his study's focus on socioeconomic factors, Zielinski examined data from 5,004 NCS participants who were age 18 or older and were not students at the time of the survey.

Results from the Study

Adults who were physically abused, sexually abused, or severely neglected as children were significantly more likely to be unemployed, living below the poverty line, and using social services than people without a history of childhood maltreatment. Having experienced more than one type of maltreatment increased these risks further.

Overall, adults who had experienced any type of maltreatment in childhood were twice as likely as non-victims to be unemployed. Childhood physical abuse and a history of multiple types of maltreatment accounted for this trend, increasing risk of unemployment by 140 percent and 190 percent, respectively. In contrast, survivors of sexual abuse or of severe neglect did not show differences in unemployment rates when compared with non-victims.

In terms of income, adults who had been physically abused as children were 60 percent more likely than non-victims to be living in poverty. The incidence rose to 180 percent for those who had experienced more than one type of childhood maltreatment.

Maltreatment was also linked to lower rates of health care coverage and greater use of social services such as Medicaid, especially among adults who had experienced childhood sexual abuse. However, Medicaid usage varied by the type of maltreatment experienced. For example, the study found that people who had been severely neglected as children were about twice as likely as non-maltreated adults to be living in poverty, thus eligible for Medicaid, but were no more or less likely to use Medicaid.

Significance

In the first comprehensive study of the long-term socioeconomic effects of abuse and neglect, Zielinski shows that childhood maltreatment carries significant costs to the individual and to society. Not only does the public share the burden in supporting maltreatment-related social services—such as child welfare services—but also those related to unemployment insurance, poverty-based public assistance, and publicly funded health insurance, such as Medicaid. Other societal impacts include the loss in employment productivity and tax revenues, from federal and state income taxes as well as state and local sales taxes.

Previous research has shown low socioeconomic status to be a risk factor for the perpetration of child abuse and neglect. Additional research has found that parents who were maltreated as children are more likely to abuse and neglect their own children than those without a history of maltreatment. Zielinski's finding that child abuse and neglect appears to contribute to low socioeconomic status in adulthood may help to explain a key factor in this "intergenerational cycle of violence." Targeted assistance for maltreatment victims may help break this cycle. For example, Zielinski suggests that enhanced access to job training and job counseling programs may be especially helpful for victims of physical abuse or multiple types of maltreatment, who were most likely to be unemployed among those who had experienced maltreatment.

What's Next

Studies that follow maltreated children over time and examine long-term socioeconomic outcomes are needed to confirm these findings. Future studies may also reveal why these associations occur, for example, why some maltreatment survivors suffer from greater unemployment rates than others or what factors influence the decision to enroll in social services. Such research may help scientists to better understand the mechanisms behind socioeconomic hardships following negative early life events and to develop treatments targeting these mechanisms.